降钙素原对患者医院感染的诊断与预后的价值研究  

Study on procalcitonin in the diagnosis and prognosis of hospital infections

作　　者：董玉梅[1] 靳桂明[1] 吴颖涛[2] 张帆[1] 曹军皓[2] 

机构地区：[1]广州军区武汉总医院感染控制科,湖北武汉430070 [2]广州军区武汉总医院检验科,湖北武汉430070

出　　处：《中华医院感染学杂志》2016年第3期682-683,686,共3页Chinese Journal of Nosocomiology

基　　金：中华医院感染控制研究基金资助项目(ZHYY2013-001)

摘　　要：目的分析医院感染患者降钙素原（PCT）的水平,探讨其对医院感染诊断及预后的评估价值。方法调查患者院内与院外感染、感染部位及预后检测PCT数据,分析治疗后效果,采用SPSS11.0软件对所有数据进行统计分析。结果 272例住院患者中院内感染83例,PCT中位值为3.2ng/ml,院外感染189例,PCT中位值为4.0ng/ml,院内与院外感染PCT的升高水平差异无统计学意义;60.8%肺部感染患者PCT0.5~2.0ng/ml,54.9%血液感染患者PCT多升高至〉2.0ng/ml,不同部位感染PCT水平差异有统计学意义（P〈0.05）;患者抗感染治疗后总有效率达83.8%,院外感染治疗有效率达87.8%,院内感染治疗有效率仅72.3%;相同PCT水平的院内及院外感染的治疗有效率差异无统计学意义;PCT水平在0.5~1.0ng/ml的患者治疗有效率25.4%,随着PCT数值的升高,治疗的有效率有所降低。结论 PCT的监测对感染患者的诊断,特别是在疾病进展为重度全身感染或脓毒血症,有较好的风险评估价值,建议临床对怀疑院内感染患者进行PCT检测,以便早期发现院内感染患者及时抗感染治疗。OBJECTIVE To analyze the procalcitonin levels in patients with hospital infections and explore the value of procalcitonin in diagnosis and prognosis of hospital infections.METHODS Data of the intra-and extra-hospital infections,infection sites and prognosis condition were analyzed in statistics by software SPSS11.0.RESULTS The median value of PCT was 3.22ng/ml in 83 inpatients who had intra-hospital infections among the 272 inpatients.The median value of PCT was 4.0ng/ml in 189 cases of extra-hospital infection.There were no significant differences in the increasing degree of PCT between intra-and extra-hospital infections.PCT was 0.5-2.0ng/ml in60.8% of the patients with pulmonary infections and reached to〉2.0ng/ml in 54.9% of hematological patients,indicating that there were significant differences in PCT levels for infections in different sites.The total effective rate of anti-infective treatment was 83.8%in all monitored patients.Among the patients with the same level of PCT,the effective rate was 87.8%for intra-hospital infections and only 72.3%for extra-hospital infections,with no statistical significance.The treatment effective rate was 25.4%for patients with PCT of 0.5-1.0ng/ml.The effective rate decreased along with the increase of PCT.CONCLUSIONPCT monitoring is of great risk prognostic value in infection diagnosis,especially in systemic infections and sepsis.To diagnose hospital infection and take anti-infective treatment in early time,it is suggested to monitor PCT of patients when suspected with hospital infections.

关 键 词：降钙素原 院内感染 院外感染 诊断 预后 

分 类 号：R446[医药卫生—诊断学]